A healthcare billing specialist manages medical claims, processes insurance and patient payments, verifies coverage, and resolves billing errors to ensure timely facility reimbursement. This role requires strong attention to detail, knowledge of medical coding, and familiarity with revenue cycle workflows.
Key Responsibilities
- Claims Processing: Submit clean medical claims electronically to insurance carriers, Medicare, and private payers daily.
- Insurance Verification: Verify patient insurance eligibility, benefits, and coverage prior to procedures.
- Denial Management: Investigate rejected or denied claims, correct coding errors, and submit timely appeals.
- Payment Posting: Post insurance and patient payments, reconcile accounts receivable (AR) aging reports, and track outstanding balances.
- Patient Communication: Answer patient billing questions, set up payment plans, and resolve billing disputes with high customer service standards.
- Compliance: Maintain patient privacy and data security in strict adherence to healthcare regulations (such as HIPAA).
Qualifications & Skills
- Education: High school diploma required; Associate's or Bachelor's degree in Finance, Accounting, or Healthcare Administration preferred.
- Experience: 1 to 3 years of hands-on experience in medical billing, coding, or accounts receivable.
- Technical Skills: Proficiency in medical billing software/ERP systems (e.g., Epic, Cerner, NetSuite) and Microsoft Excel.
- Knowledge: Familiarity with ICD-10, CPT, and HCPCS coding systems and medical terminology.
- Soft Skills: Strong analytical problem-solving, active communication, and meticulous accuracy with numbers.
- Willing to work fully remote
- Willing to work US hours
